American Journal of Epidemiology Vol. 145, No. 4: 373-379
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Association Between Toenail Selenium and Risk of Acute Myocardial Infarction in European Men
The EURAMIC Study
1Department of Epidemiology, TNO Nutrition and Food Research, Zeist The Netherlands
2Department of Epidemiology and Public Health, Agricultural University, Wageningen The Netherlands
3Departments of Nutrition and Epidemiology, University of North Carolina Chapel Hill, NC
4Department of Epidemiology and Biostatistics, Escuela Nacio-nal de Sanidad Madrid, Spain
5Medical Department, Østfold Central Hospital, Fredrikstad Norway
6Department of Preventive Medicine, University of Máiaga Málaga, Spain
7Ministry of Health, Research Centre for Preventive Medicine, Moscow Russia
8Robert Koch Institute, Berlin Germany
9Institute of Social and Preventive Medicine, University of Zürich Zürich, Switzerland
10Department of Nutrition, National Public Health Institute, Helsinki Finland
11Department of Social Medicine, Hadassah Medical Organization and Hebrew University, Hadassah School of Public Health, Ein Karem, Jerusalem Israel
12Department of Preventive Medicine, University of Granada Granada, Spain
13Cardiovascular Research Unit, University of Edinburgh Edinburgh, United Kingdom
14National Public Health Institute Helsinki, Finland
Reprint requests to Dr. Alwine Kardinaal, EURAMIC Coordinating Center, Department of Epidemiology, TNO Nutrition and Food Research Institute, P.O. Box 360, 3700 AJ Zeist, The Netherlands.
The association between selenium status and risk of acute myocardial infarction was examined in a multicenter case-control study in 10 centers from Europe and Israel in 1991–1992. Selenium in toenails was assessed for 683 nonfatal male cases with first acute myocardial infarction and 729 controls less than 70 years of age. Median toenail selenium content was 0.553 µg/g for cases and 0.590 µg/g for controls. After adjustment for age, center, and smoking, the odds ratio for myocardial infarction in the highest quintile of selenium as compared with the lowest was 0.63 . The observed inverse trend was somewhat stronger when the authors adjusted for vitamin E status (p = 0.05). Analysis stratified for smoking habits showed an inverse association in former smokers (odds ratio for the 75th-25th percentile contrast = 0.63 (95 percent confidence interval 0.43–0.94)), but not in current smokers (odds ratio = 0.97 ( 0.71–1.32)) or in those who had never smoked (odds ratio = 1.55 (0.87–2.76)). Analysis stratified by center showed a significant inverse association between selenium levels and risk of myocardial infarction for Germany (Berlin) only (75th to 25th percentile odds ratio = 0.62 (95 percent confidence interval 0.42–0.91)), which was the center with the lowest selenium levels. It appears that the increased risk of acute myocardial infarction at low levels of selenium intake is largely explained by cigarette smoking; selenium status does not appear to be an important determinant of risk of myocardial infarction at the levels observed in a large part of Europe. Am J Epidemiol 1997; 145: 373–9.
antioxidants; case-control studies; myocardial infarction; selenium
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